A blog about infertility and my journey to join the Pudding Club

From a High to a Low: Fetal growth restriction

My obstetric appointment didn’t go quite as exactly as hoped for. The doctor measured the fundal height and asked me if I had an ultrasound yet, I said no. So she said well you are going to have one today, you are measuring a small. Since I entered the third trimester I have had comments about my small bump, but the doctors say that because I am tall and have a long torso Rocky has more room upwards which is why I don’t go outwards. But then there is my weight issue, I have only put on 1lb in the past 8 weeks.

The doctor did a pelvic exam and Rocky’s head is very low down (yeh my poor bladder knows this well!), she had troubles getting to my cervix – ouchie that hurt a lot! I am 1cm dilated (how much the cervix is open, from 0-10cm) and 50% effaced (how much the cervix is thinned and shortened that means the cervix can dilate more ready for labour, from 0-100%.). Well that doesn’t mean much at 36 weeks and is perfectly fine.

I had more blood drawn and we headed in for our ultrasound. Really at this point in the pregnancy it is very difficult to tell body part from body part. These technicians are very skilled! She pointed out a head of hair….really it looked like white mess and I couldn’t tell there was even a head! As she measured Rocky’s tummy, the size was measuring 29 weeks and 30 weeks…she took the measurement several times, and everytime is showed between 29-30 weeks, way behind. But when she measured her thigh bone it measured spot on 36 weeks. Rocky’s head is way down in my pelvis so she had a hard time getting a measurement, but when she did it measured 36 weeks. With all these measurements, this meant that Rocky is weighing in at 4lbs 10oz – just under the 5th percentile for 36 weeks. Anything less than the 10th percentile is considered as growth restricted. Her tummy size is in the less than 1 percentile. That is scary. The technician confirmed that yes she was weighing in small, so went to give the results to the doctor.

We were then sent to have non-stress test. I had heard about these, where you wear two monitors, one that measures contraction strength, the other the baby’s heartbeat. You sit in a chair, relax and press a buzzer every time you feel the baby move. This monitoring goes on for at least 20 minutes depending on how active the baby is, assessing baby’s reactivity and changes in heartbeat. Rocky performed well!

After the non-stress test the doctor came back and explained her thinking. Rocky has asymmetrical intrauterine growth restriction (IUGR). Asymmetrical means that her head and length is normal, but not the stomach. In more than 70% of cases, this indicates a likely problem with the flow to and from the placenta and baby not getting enough oxygen or nutrients. Rocky diverts the energy for growing the brain and bones, meaning that the liver and fat build up doesn’t happen, which is why her tummy is so skinny. This form of intrauterine growth restriction usually occurs in the third trimester. (The other form of growth restriction is symmetric where the baby is small all over). There are other causes of this type of restriction, but most of those we can rule out. So we need to rule out the placenta problem and I have to go to Maternal Fetal Medicine specialist to have a special ultrasound to look at the flow to and from the placenta using a doppler. The catch is I have to wait for an appointment. The doctor said that I will be induced in either week 38 or 39 because the baby will do better outside my body. But if I have placenta problems she will want to induce me ASAP.

I am now on twice weekly appointments including a non stress test twice a week and an ultrasound to keep an eye on Rocky…particularly as the amniotic fluid might reduce over the coming weeks they want to monitor that and ensure that Rocky isn’t struggling getting the oxygen she needs.

I am also on ‘rest’ not bed rest exactly, but just resting and preserving all energy for Rocky. So I would have been signed off work if I wasn’t on maternity leave already.

There is no medical intervention that will stop this from happening, all that can be done is that we are both monitored closely and assess the right time to deliver Rocky.

What does this all mean for my labour, delivery and Rocky’s health? We don’t know. We know that there is an increased risk of her having problems during labour, I am more likely to need a cesarean section, there is an increased risk of still birth and perinatal mortality, she is also likely to have a number of health problems after being born in both the short and long term, or she may just be perfectly fine…but life is like a box of chocolates and you don’t know what you are going to get.

I have to remember and keep telling myself that there is nothing I did to cause this and that Rocky needs us to be strong and positive to help her make it into this world safely.

Now I just wait for my appointment with the specialist. Until we know the placenta issue, we are helpless and not knowing is quite frankly scary 😦

That sounds quite scary, I’m sorry you are going through this. Annoying that you have to wait for your appointment! Hoping that everything will be fine and that you’ll get reassurance. Thinking of you and Rocky!

It is quite amazing how much monitoring they are doing, but as our Doulas said to us last night, if they were concerned I’d be in hospital now (because they are so risk averse here in the US!!) , so that was a reassuring reminder 😊

I had a feeling after our Instagram chat that I might see a post like this. Im so sorry u are dealing with this right now. I must say that you are handling it all very graciously, which is the best for both u and baby. I know a fellow blogger, RJ also went through this with her baby girl recently. Do u follow her? I dont have her link off hand but can get it for you…They are doing great and I believe she was induced right around where u are now. Stay as positive as possible (easier said than done) and know the end is near, she will be here soon. U are doing great!

Ugh, it seems like it is just never easy. I’m sorry you have to deal with this added stress and scare. I hope you are able to get in with the specialist soon and they are able to offer you some comfort. I’ll keep you in my thoughts and hope for Rocky’s healthy, safe arrival.

Ahhh yes, there had to be catch somewhere right???!!! It’s funny because last night when we spoke with the Doulas they remarked at how chilled we were about it all, we pointed out that all the IF stuff has prepared us well for coping with unexpected news together! Thank you for your thoughts 😊

Oh I am so sorry you are experiencing this. One of the other bloggers I follow (and you may too) had this and had to be induced early. She had a happy healthy baby girl in her arms now and I am hoping the same for you 🙂

Hi, I had IUGR too.. small belly, the baby wasn’t growing etc. They induced two weeks early because although he wasn’t growing as they hoped the placenta was working fine. I do agree the baby is better out than in to make the best chance of growth in the best environment. Embrace the C-section, don’t stress or worry, you will just get to meet your little one sooner than planned!! 🙂

I was telling Chris about your story the other day 😊 I will say that it has made me think a whole lot more about embracing a C-section, I think I need to spend more time thinking about it to be comfortable over the next few days 😊

Oh gosh, I’m so sorry you’re having these worries. That must be scary. But it sounds like the regular monitoring means they will figure out the best time for Rocky to make her appearance and that could be really soon! I am sending you good vibes and hoping for a great birth experience for you. X

That is great! I think having experienced doulas or midwives who you trust really helps you feel better about things. I felt a lot of anxiety until they confirmed I would just have L who I know and trust. (Others on the NHS get a random whoever is on duty but I’m classed as “high anxiety”/special needs/high risk due to age / IVF / GD so they thought I’d benefit from an assigned midwife.

Also the thing about sizes is I did some reading and the accuracy seems kind of out in many ways. For example we’ve been told B is measuring 95th percentile on the NHS and 55th on private. That is a big difference. Hopefully the fact that US is private means you get the regular monitoring and extra attention to make sure everything runs as smoothly as it can!

How scary for you. After everything I think you guys deserve an easy ride! At least the medics are on it and monitoring things, so you and Rocky are in the best possible hands. Also, you’re basically “at term” if they need to act quickly to get little Rocky out. It must be very scary though, just waiting and not being able to actively do anything. I’m thinking of you and really hope there are no short or long term complications for Rocky x x x

How scary for you. After everything I think you guys deserve an easy ride! At least the medics are on it and monitoring things, so you and Rocky are in the best possible hands. Also, you’re basically “at term” if they need to act quickly to get little Rocky out. It must be very scary though, just waiting and not being able to actively do anything. I’m thinking of you and really hope there are no short or long term complications for Rocky x x x

Oh my gosh, how scary! I’m glad you’re getting lots of medical attention, and that they had the foresight to do an ultrasound for you. I’ll keep my fingers and toes crossed that Rocky keeps developing, and we’ll get to see her beautiful face in about two weeks. Sending *hugs*

Hello! I was told to come check you out as your little one was diagnosed with IUGR. I’m so sorry, it’s super scary but you have a fantastic attitude. I hope your appt with the MFM went well. My little one had symmetric IUGR diagnosed at 30 weeks. I have a unicornuate uterus (half uterus) and unfortunately it’s s common complication for UU pregnancies. She was born at the 0th percentile via induced vagunal delivery 37 weeks. Tolerated labor just fine with a little hiccup at the end. Our only complication post delivery was low blood sugars. She was 4lb 13oz. She’s 10 weeks now and weighs 10lb 2oz! So far meeting milestones but a terrible sleeper, which I’m sure has nothing to do with the IUGR.

4lb 10oz sounds pretty good to me. I hope you get the labor you dreamed of. My MFM always told me the biggest predictor of success is GESTATIONAL AGE and 36 weeks already is great. If you have any questions or need support from someone who has been there, especially post delivery, feel free to contact me. Rayeraye09@gmail.com or leave a message on my blog. I’m a terrible blogger but I love following others stories and commenting. Good luck and best wishes.

Awww thank you for stopping by to share your story! it’s great to hear you had a vaginal delivery just fine. You must have been very nervous. I am hoping for a successful vaginal delivery is what will happen next week for us 🙂 Thank you so so much for your kind words, very helpful indeed!

catching up on blogs – so sorry to hear this. As previous commenters have mentioned – sounds like you are being closely monitored and well taken care of. You are in the home stretch – keep thinking positive thoughts and taking care of yourself. Best wishes 🙂